Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 00864 | Date 31/08/2018 |
| Token No | SM/18-19/3759 15/11/2018 | Serial | 054 Last Visit: 03/12/2025 |
| Patient Name | Mrs. ALPONA SOM | Contact No | 9051868267 |
| Address | 123/A CHATRA BARUI PARA LANE | Age | 49 Years,11 Months,1 Days Female |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 75 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||